Cocanour C S, Miller-Crotchett P, Reed R L, Johnson P C, Fischer R P
Department of Surgery, University of Texas Medical School Houston.
J Trauma. 1992 Jan;32(1):12-5. doi: 10.1097/00005373-199201000-00003.
Cutaneous mucormycosis is a rare but often fatal infection in trauma patients. We retrospectively reviewed a 9-year experience with mucormycosis among injured patients. Eleven patients had biopsy- or culture-proven mucormycosis. Nine patients were victims of blunt trauma, two patients had burns measuring greater than 50% TBSA. No patient was at increased risk because of underlying disease or immunosuppression prior to injury. All 11 patients had open wounds on admission. Four patients died of mucormycosis. All nonsurvivors had phycomycotic gangrenous cellulitis of the head, the trunk, or both. In contrast, survivors had involvement of only the extremities. Because of underlying disease, contaminating wounds, antibiotic use, or immunocompromise secondary to shock and sepsis, trauma patients are at risk of developing mucormycosis. To successfully treat mucormycosis, diagnosis must be prompt and accompanied by aggressive debridement and parenteral administration of amphotericin B.
皮肤毛霉病在创伤患者中是一种罕见但往往致命的感染。我们回顾性分析了9年间受伤患者毛霉病的诊治经验。11例患者经活检或培养确诊为毛霉病。9例患者为钝器伤受害者，2例患者烧伤面积超过总体表面积的50%。受伤前没有患者因基础疾病或免疫抑制而处于高风险状态。所有11例患者入院时均有开放性伤口。4例患者死于毛霉病。所有非幸存者均有头部、躯干或两者的藻菌性坏疽性蜂窝织炎。相比之下，幸存者仅累及四肢。由于基础疾病、污染伤口、使用抗生素或休克及脓毒症继发的免疫功能低下，创伤患者有发生毛霉病的风险。要成功治疗毛霉病，必须迅速诊断，并积极进行清创和静脉注射两性霉素B。
